Back Care Advice. Physiotherapy Department. Advice Leaflet. University Hospitals of Leicester

Transcription

1 If you would like this information in another language or format, please contact the Service Equality Manager on University Hospitals of Leicester NHS Trust Back Care Advice Physiotherapy Department Haddaad rabto warqadan oo turjuman oo ku duuban cajalad ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta Advice Leaflet Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını isterseniz lütfen servis müdürüne telefonundan ulaşabilirsiniz. The aim of this leaflet to help you care for your back and prevent further injury. Date of production: 2004 / Last reviewed October 2009

2 ADVICE Back pain is a very common problem but it is usually not due to any serious disease. Most backache settles quickly, or at least enough for you to get on with normal life. If you have any concerns or queries regarding the information in this booklet then please contact your physiotherapist. Many people experience more than one episode of backache in their life, but it still does not mean it is serious. Most people return to normal activities with few if any symptoms. Back pain can be very painful and there are times when you may need to reduce your activities. However, rest for more than a day or two usually does not help, and may do more harm than good. SO KEEP MOVING... Your back is designed to move. The people who cope best are those who stay active and get on with their lives, despite discomfort. A positive attitude is best. Do not let your backache rule your life. Hurt does not necessarily mean harm. In most people we cannot pin point the exact source of the trouble. While it is frustrating not knowing exactly what is wrong, it helps to know you do not have any serious damage. CAUSES OF BACK PAIN The spine is made up of solid bony blocks, called vertebrae, which are joined by discs to give it strength and flexibility. It is surrounded by large and powerful muscles to protect it. It is hard to seriously damage your spine. Few people have backache have a slipped disc, or trapped nerve. Referral or spread of symptoms to a limb or limbs does not always mean you have sciatica. 1 Compiled by UHL Physiotherapy Department March 04 Last reviewed March 05 Contacts Leicester General Hospital (0116) Direct Dial Leicester Royal Infirmary (0116) Physio Dept Glenfield Hospital (0116)

3 Sleeping on Side Place pillow between knees. Use cervical support under neck and a roll around waist as needed. In/Out of Bed Lower self to lie down on one side by raising legs and lowering head at the same time. Use arms to assist moving without twisting. Bend both knees to roll on to back if desired. To sit up, start with lying on side and use the same movements in reverse. Keep upper body aligned with legs. Dressing Most x-ray changes are normal changes with age, or wear and tear. X-ray changes do not always reflect the degrees of pain you experience. Exercise is still good for you. Most backache comes from muscles, ligaments and joints, which are not working as they should. Think of your back as out of condition. Stress can aggravate the amount of pain you feel. Tension can cause muscle spasm and muscles themselves can become painful. People who are physically fit generally get less pain and recover quicker. The answer is to get your back moving and working again properly. ADVICE FOR ACUTE EPISODES OF BACK PAIN Previously the treatment of back pain was prolonged rest. However, there is no evidence that bed rest for more than a day or two is beneficial and may have an adverse effect. Long periods of bed rest cause: Your bones and muscles to become weaker Your joints to stiffen Physical fitness deteriorates The pain to worsen You often get depressed Once you confine yourself to bed it becomes harder to get going again. Lie on back to place socks or trousers over feet, or bend leg up while keeping back straight. 21 When your pain is bad you may need to do less. You may even be forced to have a day or two in bed at the start, ie. After the initial strain or injury, but it is important to get moving as soon as you can. 2

4 If you can, keep moving, potter around the house. Take painkillers prescribed/advised by your GP. Pay attention to your posture. Avoid sitting about for long periods in soft un-supporting chairs. Avoid lying slumped in bed without a change of position. Avoid twisting/bending/and lifting. Keep changing position to avoid stiffness. Change position every minutes. Gradually get yourself moving/pottering. Progress a little bit more each day. Remember your body must stay active to stay healthy. IF YOUR BACK PAIN IS SIGNIFICANTLY INCREASED, THE FOLLOWING ADVICE MAY BE USEFUL FOR THE FIRST FEW DAYS UNTIL THE PAIN SUBSIDES. Sleeping on back Place pillow under knees. A pillow with cervical support and a roll around waist are also helpful. Log Roll Lying on back, bend left knee and place left arm across chest. Roll all in one movement to right. Reverse for rolling to left. Always move as one unit. Knees Into Bed Get on hands and knees before lowering self. Reverse process to get up. 3 20

5 CHILDCARE Childcare Picking up From Floor Squat down to pick up baby and bring close before standing up. Use knees and keep back straight. Childcare Holding Use pillows to help position during feeding. Lifting Principles Maintain proper posture and head alignment. Slide object to be lifted as close as possible. Move obstacles out of the way. Test before lifting, ask for help if too heavy. Tighten stomach muscles without holding your breath. Use smooth movements, do not jerk. Use legs to do the work and pivot with your feet. Distribute the workload symmetrically and close to the centre of trunk. Push instead of pull whenever possible. Ask For Help Ask for help and delegate to others when possible. Coordinate your movements when lifting together and maintain the low back curve. Childcare In/Out of Bath Squat or kneel down close to edge of bath to lower child into bath or lift out. Be sure there is a safety mat inside. Overhead Shift weight from front foot to back as item is lifted off shelf 19 4

6 Reducing Load Childcare Carrying Move heavy items one at a time, or move portions or the contents. Carrying Luggage Distribute weight evenly on both sides. Use a cart whenever possible. Do not twist body. Move body as a unit. Keep baby close and as upright as possible. Childcare In / Out of Car Stand close and keep back straight. Bend knees to put baby in or take baby out of car seat. Deep Squat Squat and lift with both arms held against upper body. Tighten stomach muscles without holding breath. Use smooth movements to avoid jerking. 5 18

7 Car One Knee Slide object up one thigh and hold close at waist level with both hands before standing up. Before driving, adjust seat and steering (if tilt control) to ensure good posture. Lambskin and a lumbar roll can be used for positioning whether riding or driving. Work Positioning Position self close to work whether standing or sitting. Avoid straining forward at neck or waist. Car Boot Unloading Place one foot on bumper slide items close before lifting. 6 17

8 Trolley When reaching into trolley, lift opposite leg to keep back straight. Work Height & Reach Ideal work height is no more than 2 to 4 inches below elbow level when sitting. Reaching should be limited to arm s length with elbows slightly bent. Getting Into / Our of Car Computer Work Position work to face forward. Use proper work and seat height. Keep shoulders back and down, wrists straight and elbows at right angles. Use chair that provides full back support. Add footrest and lumbar roll as needed. Lower onto seat, scoot back then bring one leg in at a time. Reverse to get out. 7 16

9 Posture Sitting Pushing / Pulling Sit upright, head facing forward. Try using a roll to support low back. Keep shoulders relaxed, avoid rounded back. Keep hips level with knees. Avoid crossing legs for long periods. When reading, hold material in tilted position and maintain good sitting posture. Pushing is preferable to pulling. Keep back in proper alignment and use leg muscles to do the work. Avoid Twisting Alternating Positions Alternate tasks and change positions frequently to reduce fatigue and muscle tension. Take rest breaks. Avoid twisting or bending back. Pivot around using feet movements and bend at knees if needed when reaching for articles. 15 8

10 ACTIVITIES OF DAILY LIVING Housework Sink or brushing teeth ADVICE ON POSTURE The Spine To keep your spine healthy, follow your home program instructions. Place one foot on ledge of cabinet under sink when standing at sink for prolonged periods. Laundry Unloading Dryer/Washing Machine Posture Standing Good posture is important. Avoid slouching and forward head thrust. Maintain curve in low back and align ears over shoulders, hips over ankles. Squat down to reach into clothes dryer. Small items can be placed in a large zippered mesh bag and pulled out using a reacher. 9 14

11 Gardening Digging Laundry Basket Insert tool vertically into soil and step back on blade, then lift out small amounts. Gardening Raking Squat down and hold basket close to stand. Use leg muscles to do the work Laundry Ironing Move close to area to be raked. Use arm movements to do the work. Keep back straight and avoid twisting. Use proper work height to keep back straight. Place one foot on low stool

12 Housework Vacuuming Gardening Mowing Hold the vacuum with arm held at side. Step back and forth to move it, keeping head up. Avoid twisting. Keep arms close to sides and walk with lawn mower. Gardening Weeding/Planting Refrigerator / Dishwasher / Cleaning Squat with knees apart to reach lower shelves and drawers. Squat or kneel. Knee pads may be helpful